Enabling vs. Providing “Infrastructure” for Family Planning (and a Map of Government-Funded Family Planning Providers in Texas)

It’s not just right wing, Christian “anti-choicers” (we really prefer to be called “pro-life”) who understand that paying abortion providers and those who refer to them under Medicaid and Title X funds enables them to do abortions. From the Guttmacher Institute:

Title X is a grant program under which funds are distributed to grantees who design and operate their own programs—funding can be targeted to local needs and challenges. Unlike Medicaid, for example, Title X can subsidize the intensive outreach necessary to encourage some individuals to seek services. Furthermore, by paying for everything from staff salaries to utility bills to medical supplies, Title X funds provide the essential infrastructure support that enables clinics to go on and claim Medicaid reimbursement for the clients they serve.

So, whoever receives Title X funding is “enabled” to stay in business. In these days of low tax revenues and high demand, shouldn’t Texas only “enable” comprehensive, continuing care?

Unfortunately, Texas representatives of Texas taxpayers found themselves limited in funds this year and we had to prioritize where we allocated Family Planning money. Funding for the Family Planning programs and the Texas Women’s Health Program, which receives Medicaid money, was directed toward programs and doctors that offer continuing, comprehensive care, such as Federally Qualified Health Centers (FQHC), State, County and local clinics and hospitals, and fee for service doctors that participate with Medicaid.

However, in article after article, the law which sets aside money to pay for contraceptives and never mentions Planned Parenthood, is said to have been a weapon in the war on contraceptives and abortion, and in particular, against Planned Parenthood.

Medicaid is supposed to be a health program for the very poor, but Congress has allowed States some flexibility when it comes to the disabled and to pregnant women, through a system of waivers. Texas began our Women’s Health Program in 2007, asking for a waiver to spend funds to screen women for disease, including high blood pressure, diabetes, and even tuberculosis, not just for STD’s, breast cancer and cervical cancer. The program also pays for the prescription and dispensing of contraception – including Natural Family Planning! – to women who are not pregnant or disabled, and who would not otherwise be eligible for Medicaid.

The Obama Administration’s Department of Health and Human Services has refused this year’s request for a waiver to apportion the funds because of the stipulation that the State’s money will not go to affiliates of those who either perform or refer to elective abortions.

Just to be clear, “elective abortions” mean those that are done because the healthy mother carrying a healthy child seeks an abortion, not those done to prevent damage to her health or save her life. “Elective abortions” don’t even include those done in healthy mothers with healthy babies who were conceived through rape or incest. Procedures to treat tubal or ectopic pregnancies are never considered abortions, either “elective” or medical.

The law, HB 7, passed in the Special Session of the 82nd Legislature does not mention Planned Parenthood or any other abortion provider. The text stresses that our State must prioritize how we are to spend our limited tax dollars:

(a)Notwithstanding any other law, money appropriated to the Department of State Health Services for the purpose of providing family planning services must be awarded:

(1) to eligible entities in the following order of descending priority:
(A) public entities that provide family planning services, including state, county, and local community health clinics and federally qualified health centers;
(B) nonpublic entities that provide comprehensive primary and preventive care services in addition to family planning services; and
(C) nonpublic entities that provide family planning services but do not provide comprehensive primary and preventive care services; or
(2) as otherwise directed by the legislature in the General Appropriations Act.
(b) Notwithstanding Subsection
(a), the Department of State Health Services shall, in compliance with federal law, ensure distribution of funds for family planning services in a manner that does not severely limit or eliminate access to those services in any region of the state.

(b) Section 32.024, Human Resources Code, is amended by adding Subsection (c-1) to read as follows:
(c-1) The department shall ensure that money spent for purposes of the demonstration project for women ’s health care services under former Section 32.0248, Human Resources Code, or a similar successor program is not used to perform or promote elective abortions, or to contract with entities that perform or promote elective abortions or affiliate with entities that perform or promote elective abortions.

The Texas Tribune has published a map of family planning clinics in Texas, claiming to point out which clinics will stop receiving taxpayer money in March of this year.

In Texas, the Legislature has drastically reduced funding for family planning agencies that serve low-income women statewide. There are 41 agencies that receive funding today, down from 71 last year. Those organizations often operate multiple clinics that provide Texans with contraceptives and disease screenings.

Using the most up-to-date information available through the Texas Department of State Health Services, we have mapped out the locations of government-subsidized family planning clinics in 2010, 2011 and 2012. Not only are there fewer contractors each year, but those that receive grants are getting less money. During the 2011 session, lawmakers redirected virtually all state funds that have traditionally gone to family planning services to other programs. Today, nearly all public funding for these clinics comes from the federal government’s four-decade-old Title X program, which is dedicated to family planning.


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